Definition and Classification of Negative Motor Signs in Childhood

TLDR

Motor disorders in children include weakness, reduced selective motor control, ataxia, apraxia, and developmental dyspraxia, each defined by specific impairments in force generation, muscle isolation, movement trajectory, complex action execution, or acquisition of age‑appropriate motor skills. The meeting aimed to create standardized terminology and definitions for weakness, reduced selective motor control, ataxia, and praxis deficits to improve clinical communication, research grouping, outcome measurement, and therapy matching. A consensus meeting of 39 specialists across pediatrics, neurology, surgery, therapy, and biomechanics disciplines was convened to develop the definitions. The consensus meeting produced agreed definitions for the five motor disorder categories, establishing a common framework for future research and clinical practice.

Abstract

In this report we describe the outcome of a consensus meeting that occurred at the National Institutes of Health in Bethesda, Maryland, March 12 through 14, 2005. The meeting brought together 39 specialists from multiple clinical and research disciplines including developmental pediatrics, neurology, neurosurgery, orthopedic surgery, physical therapy, occupational therapy, physical medicine and rehabilitation, neurophysiology, muscle physiology, motor control, and biomechanics. The purpose of the meeting was to establish terminology and definitions for 4 aspects of motor disorders that occur in children: weakness, reduced selective motor control, ataxia, and deficits of praxis. The purpose of the definitions is to assist communication between clinicians, select homogeneous groups of children for clinical research trials, facilitate the development of rating scales to assess improvement or deterioration with time, and eventually to better match individual children with specific therapies. "Weakness" is defined as the inability to generate normal voluntary force in a muscle or normal voluntary torque about a joint. "Reduced selective motor control" is defined as the impaired ability to isolate the activation of muscles in a selected pattern in response to demands of a voluntary posture or movement. "Ataxia" is defined as an inability to generate a normal or expected voluntary movement trajectory that cannot be attributed to weakness or involuntary muscle activity about the affected joints. "Apraxia" is defined as an impairment in the ability to accomplish previously learned and performed complex motor actions that is not explained by ataxia, reduced selective motor control, weakness, or involuntary motor activity. "Developmental dyspraxia" is defined as a failure to have ever acquired the ability to perform age-appropriate complex motor actions that is not explained by the presence of inadequate demonstration or practice, ataxia, reduced selective motor control, weakness, or involuntary motor activity.